Health care for a visitor to the United States is cash on the barrelhead, even if you have insurance.

Let me set the table: I thought I had the worst case of flu in this town, until I was bumped out of first place — worst place — when a colleague trumped me by coughing blood.

Runner-up is still pretty bad, and I was feeling sorry for myself until a reader sent me a short, sharp, nasty note to say she not only had the flu but, unlike me, she had to look after a sick kid at the same time.

My misery had no company from her.

I was about to let the matter slide, and continue slowly onward with my persistent cough, when I got a note from Hans De Ree.

Hans said he’d had the flu on holiday in the United States. I was instantly curious.

There is not here.

I wanted to compare notes.

I had symptoms bad enough to warrant 19 hours in emergency, an X-ray, an ultrasound, a CT scan and an hour’s worth of MRI.

I was actually too ill to be frightened. Or, as my dearest says, I was too stoned, thanks to the sweet and steady flow of intravenous painkillers.

But I knew it was fairly serous when I asked for tea, and the doctor told me that was not a good idea, in case they had to operate.

Yikes.

As you can see, I remain among the living, and the only cost to me for all that time, care and attention — and all those tests — was the cost of the prescription I took home.

Not quite true.

This is Canada. I have been paying taxes all my life. But what happened to Hans in the States, where health care, in spite of Obama, is still different?

Hans told me his story over a cup of coffee in a north-end mall the other day. He is a lovely guy, a retired electronics technician.

He’d gone with a friend to Livermore, Calif., across the bay from San Francisco. “We go for five weeks every year; my friend has a daughter there; her daughter is a nurse.” And?

“I was coughing and coughing. I felt lousy.” His friend’s daughter urged him to go to a clinic; better safe than sorry, so he went.

“I told them I didn’t have American insurance; they asked this right at the start. I said I was going to claim it on my travel insurance. They told me if I’d had no insurance, they’d have given me a 40-per-cent discount.”

This week’s special?

Fever, aches and chills.

“The doctor looked at me, tested me, did an oxygen uptake, checked my throat, took a couple of X-rays.

“I was told it was a virus, and not to take any medication for five or six days, but if it doesn’t go away to take the medication.”

Was it a nice clinic?

Hans said, “Nothing but the best, I guess because it’s pay as you go.” Was it crowded? “I was the only one there.” Perhaps he was the only one there because it’s pay as you go.

To shorten the story, he paid $250 cash on the barrelhead, for the examination and treatment, and they sent him a further set of bills.

The clinic cost was $1,466 in total; he paid $45 for his prescription, plus $382 for the attending physician, and $47 for the doctor who read the X-rays.

Grand total?

$1,939.99

“I paid the doctor on my credit card.” The good news? His insurance is covering virtually all his costs.

He’d have been on the hook for all of it if he hadn’t had travel insurance, for which he paid $500.

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